Article Medically reviewed by Dr. Gavin Chan (MBBS, cosmetic physician, liposuctionist)
Templestowe Lower and Berwick Clinics
Dr. Gavin Chan has a background in intensive care, anaesthesia, and emergency medicine. Since 2004, Dr. Chan has provided cosmetic procedures, including anti-wrinkle injections, dermal fillers, liposuction, fat transfer, skin needling, and laser treatments. He is a doctor trainer for various dermal fillers and anti-wrinkle injections.
What is the Fraxel laser Re:store Dual laser and what is a fractional laser?
The Fraxel laser was the first ‘fractional’ laser made for the treatment of acne scars, surgical or traumatic scars, skin pigmentation (including freckles, solar lentigos and melasma), sun damaged skin, and wrinkles. Fractional lasers fire microscopic columns of laser energy into the skin, sparing the skin in between these columns. This allows for effective treatment of skin with less downtime and less risk. Fractional lasers also allow a greater range of skin types to be treated in comparison to non-fractional lasers. In particular there is more scope for the treatment of olive or darker skin types with less risk of pigmentation problems post-treatment in comparison to non-fractional lasers.
One of the key advantages of the Fraxel Re:store Dual laser, is that it does not remove top layers of skin. Instead it simply heats micro-columns of skin which induce new collagen production. This minimises downtime. However, multiple sessions are usually required for optimal outcomes.
Fraxel Case Study
This patient presented to Victorian Cosmetic Institute with pigmentation concerns, in particular the larger spot above her eye brow. This is her before and after treatment with the Fraxel laser using the 1927nm wavelength. There is a significant improvement in her general skin tone and texture.
What are the effects of the Fraxel Re:store Dual laser wavelengths on the skin?
The Fraxel Re:store Dual laser has two wavelengths, 1550 nanometers (nm) and 1927nm, each suited to the treatment of different skin conditions. The 1550nm and 1927nm wavelengths are primarily attracted to the water in the skin. As one of the main constituents of skin is water, this causes the laser energy to be converted to heat energy within the skin. This induces remodeling and regeneration of skin to address various skin concerns. As the name suggests, Fraxel is fractional in nature (only some of the skin is treated). This results in improved healing times, and reduced risk.
The 1550nm wavelength is quite a deep penetrating laser wavelength and can penetrate up to 1.4mm into the skin, which makes it the ideal for the treatment of deeper problems such as acne scarring or other types of scarring. The laser wavelength induces controlled zones or columns of coagulated tissue in the dermis, also known as microthermal zones (MTZs) which are repaired and remodeled. The 1550nm wavelength produces deep but thin columns of laser energy into the skin. This reorganises and regenerates collagen to help to lift indented scars such as those from acne, or to smooth and flatten traumatic or surgical scars.
The 1927nm wavelength addresses more surface problems of the skin. Being more avidly attracted to water than the 1550nm wavelength, the 1927nm wavelength only penetrates superficially before its energy is quickly taken up by the water in the skin and converted to heat energy. It produces bigger but more superficial columns of laser energy than the 1550nm and can be used to cover a greater percentage of the skin’s surface area. The 1927nm wavelength is very useful for the treatment of superficial pigmentation, freckles and sun damage.
Depending on the type of skin and skin problem treated, it is also possible to use both 1550nm and 1927nm wavelengths in the same session to target the skin at different depth.
Freckle treatment is particularly effective with the 1927nm wavelength and is one of our most effective lasers for this indication.
Melasma is a common pigmentation problem seen in mostly in women. It tends to be both a deep and superficial pigmentation problem and is an example of a condition that can be treated by both or either wavelengths of the Fraxel. Melasma also tends to occur on olive or darker skin types, and as the Fraxel is fractional in nature, it can be used safely and effectively on these skin types. Our preferred laser treatment for melasma is the PiQo4 laser which tends to cause fewer complications such the exacerbation of pigmentation post-laser.
For scarring, including acne scarring, the Fraxel laser is less effective than Infini (radiofrequency combined with micro-needling) and fractional carbon dioxide laser treatments.
Figure: Shows a before and after photo one week post single 1927nm Fraxel treatment for melasma.
Freckles can also be effectively treated with the Fraxel laser. Freckles reside in the more superficial layers of the skin, and are generally widespread across the face. They are approximately the size of a matchstick head. The advantage of treatment with the Fraxel laser is that it can very uniformly treat the skin allowing for a consistent and even treatment. It achieves this by using a scanner that is rolled across the face.
Both wavelengths can also be used on the face as well as the body, including the neck and decolletage.
Video case study - Sharron Farrell has Fraxel 1927nm for freckle removal
What is involved with Fraxel treatment?
The first step in Fraxel treatment is for one of our doctors to assess your skin’s suitability for the treatment. Not all skin conditions and skin types are suitable, or there may be another laser that is more suited to your concerns. If the Fraxel is suitable for you, we then select the most suitable Fraxel wavelength (1550nm or 1927nm) to your skin concern/type.
Standardised clinical photographs of the skin are taken for the purposes of before and after comparison.
Usually, topical anaesthetic cream is applied for about 1 hour prior to treatment, and this sufficiently numbs the skin to make the Fraxel treatment comfortable. Nitrous oxide, or laughing gas, can also be used to help relieve the discomfort from the treatment and relieve any anxiety with treatment.
The Fraxel laser treatments are also always performed with a Zimmer cooler. This machine blows cold air over the treated areas during treatment. This serves the purpose of reducing discomfort from the procedure, as well as reducing unnecessary heat energy build up in the skin.
The Fraxel laser has a patented scanning hand piece that fires columns of laser into the skin. It uses an Intelligent Optical Tracking System (IOTS) to fire the laser consistently into the skin irrespective of the speed of movement of the hand piece by the operator. Usually several passes are performed to achieve the necessary end-point required. The total treatment time (laser time only) of the face is usually around 20 minutes.
After treatment the skin feels warm and looks red. The intensity and duration of side effects depends on the level of the treatment. Redness and swelling usually persist for a few days, but in more aggressive treatments, can persist for longer. There can also be some mild peeling or bronzing effect on the skin post treatment that lasts about a week.
In summary, Fraxel laser is primarily used for the treatment of scarring, pigmentation problems, including melasma, sun damage and general improvement of skin quality, tone and texture. Treatments are performed by a laser therapist or nurse and overseen by a doctor. There are two different wavelengths (1927nm and 1550nm) for the treatment of different skin concerns. The 1927nm wavelengths is primarily for problems such as melasma, skin pigmentation, sun damage, and improving skin quality, tone and texture. The 1550nm wavelength is primarily for the treatment of acne scarring, and other forms of scarring.
Fraxel recovery progression and before and after photos
This is a patient in her thirties with fair skin who was concerned with sun damage and freckles. She had a Fraxel 1927nm treatment which focuses on the superficial layers of the skin where sun damage and freckles reside. The settings used on the Fraxel were high settings, requiring approximately one week of downtime. The photos here show her before Fraxel, day 1,3,6,10 and 8 months later.
Why choose Victorian Cosmetic Institute as your provider of Fraxel laser treatments?
Victorian Cosmetic Institute has the latest version of the Fraxel laser with the dual wavelengths 1550nm and 1927nm. Our staff have been highly trained in Fraxel laser treatments. Your treatment will be performed by experienced practitioners.
Furthermore, we have a wide range of other lasers to choose from for the treatment of your skin. This means that we are able to select the best laser for treatment for you. Clinics with a limited number of lasers may overly extend the use of one laser to cover their requirements, and this may not an ideal laser for your skin or skin concern.
Otherwise, you can phone us directly on 1300 863 824.